Staging of Prostate Cancer

At diagnosis, your prostate cancer will be classified in accordance with its prevalence or progression within the body as either confined to the prostate or further distributed to surrounding organs or tissues. Specifically, prostate cancer is staged on a scale of one (low-grade) to four (high-grade) using:

  • 1) The size and extent of primary tumour
  • 2) Whether cancer cells have spread to nearby lymph nodes
  • 3) Whether cancer cells have spread to other tissues or organs of the body

Your prostate cancer will have been staged using any of the following procedures: physical exams, medical imaging, laboratory tests, pathology reports and surgical reports. Staging of prostate cancer is important for you and your physician, enabling a treatment plan or pathway to be developed for your cancer to be managed, and to predict chance of recovery.

There are often numerous factors to consider, specific to the lobe(s), prostate-specific antigen (PSA) levels, Gleason scores and detection methodologies. Listed below are general guidelines that are indicative (not exhaustive) of each Stage classification.

  • Stage 1:
    • Cancer is located in the prostate only; normally detected through needle biopsy in response to high PSA level. PSA level is below 10 and Gleason score is 6 or lower to be considered for this Stage. Cannot be felt by digital rectal examination and cannot be seen through imaging tests. Cancer is found in one-half or less of one lobe of the prostate.
  • Stage 2a:
    • More advanced than Stage 1, however, still remains localised to the prostate. Detected through needle biopsy in response to high PSA level. PSA level is below 20, Gleason score is 7.
  • Stage 2b:
    • More advanced than Stage 1 or 2a, however, still remains localised to the prostate. Detected through needle biopsy in response to high PSA level. PSA level is often 20 or higher, Gleason score between 2 to 10. Cancer is found in opposite sides of the prostate.
  • Stage 3:
    • Cancer has spread beyond the outer layer of the prostate, and may have spread to the seminal vesicles. PSA can be any level, Gleason score ranges from 2 to 10.
  • Stage 4:
    • Cancer has spread beyond seminal vesicles to nearby tissues or organs, such as nearby lymph nodes, bone, bladder, rectum or pelvic wall. May have also spread to distant parts of the body.

Men can safely participate in exercise at any stage of disease progression. However, the more advanced stages of prostate cancer will require greater levels of supervision and individually tailored exercise programs for your unique condition. Therefore, use the beginner, advanced or special programs provided on this portal for guidance only, in consultation with your local or remote accredited exercise physiologist who specialises in cancer management!